Individual
ERICA ANNE HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSCCC-SLP
Contact information
Practice address
890 N COLE RD, SUITE A, BOISE, ID 83704-8638
(208) 323-8888
(208) 323-8889
Mailing address
2251 S BAYOU BAR WAY, MERIDIAN, ID 83642-4519
(208) 887-6370
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1470
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09129978
ASHA
—
01
—
SP979
BLUE CROSS INSURANCE
ID
Enumeration date
01/31/2007
Last updated
07/08/2007
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